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longer flights and residual gas pain or surgeon clearance may extend it."},"follow_up_visits":[{"purpose":"result_review","requirement":"routine","after":{"min":7,"max":21,"unit":"days","qualifier":"Review of histology and wound healing."}},{"purpose":"assessment","requirement":"conditional","after":{"min":30,"max":90,"unit":"days","qualifier":"Clinical or ultrasound reassessment, e.g., for recurrence or ovarian reserve concerns."}}],"indications":["Symptomatic benign ovarian cysts (pain, pressure) not resolving with observation","Persistent or enlarging endometrioma, dermoid, or cystadenoma","Torsion risk or rupture-related symptoms (selected cases)"],"main_risks":["Bleeding","Infection","Reduced ovarian reserve from removal of normal ovarian tissue","Injury to bowel, bladder, ureter or vessels","Cyst recurrence","Postoperative adhesions","Anesthesia-related and pneumoperitoneum-related complications","Conversion to open surgery"],"pain":"Mild to moderate pain in the first few days, plus shoulder-tip pain from gas; usually controlled with oral analgesics.","preparation":["Pelvic ultrasound or MRI, sometimes tumor markers","Pre-anesthesia assessment and routine blood tests","Pregnancy test","Fasting before general anesthesia per anesthesia team","Discussion of fertility goals and ovarian reserve","Review of medications with the surgical team"],"recovery_timeline":[{"phase":"Day of surgery","description":"Recovery from anesthesia, early walking, discharge the same day or next morning.","restrictions":["No driving","Avoid heavy activity"]},{"phase":"Days 2-7","description":"Gradual decrease of pain, bloating and shoulder pain; small incisions heal.","restrictions":["No heavy lifting","Keep incisions clean and dry"]},{"phase":"Weeks 2-4","description":"Return to normal daily activity and gradual return to exercise.","restrictions":["Avoid strenuous exercise until week 4","No sexual activity until about week 2"]}],"rehabilitation_days":{"min":7,"max":14,"unit":"days","qualifier":"Ordinary functional recovery for daily activities after uncomplicated surgery."},"result_longevity":"The removed cyst is permanent, but new cysts or endometrioma recurrence can occur; risk depends on underlying cause.","revision_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Repeat surgery for cyst recurrence within 2-5 years; higher for endometrioma, lower for other benign cysts"},"scars":"Usually 3-4 small incisions of about 0.5-1.5 cm, typically fading to inconspicuous scars.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operative procedure."},"stages":[{"code":"surgery","label":"Laparoscopic cystectomy","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on day of procedure."}}],"qualifier":"One surgery for a typical unilateral uncomplicated case."},"success":{"metric":"Symptom relief (pain resolution) after cystectomy","value":85,"unit":"percent of patients","horizon":"3 months","population":"Adult women with symptomatic benign ovarian cysts, including endometrioma","evidence_status":"limited"},"techniques":[{"name":"Standard multiport laparoscopic stripping cystectomy","suits_whom":"Most benign cysts, including endometriomas and dermoids, in patients wanting ovarian preservation.","recovery":"Typically same-day or 1-night stay, return to light work in about 1-2 weeks."},{"name":"Single-incision (single-port) laparoscopic cystectomy","suits_whom":"Selected patients with simple benign cysts and an experienced surgeon, for cosmetic preference.","recovery":"Similar to multiport recovery."}],"treatment_conditions":["day_case","inpatient"],"treatment_duration_hours":{"min":0.5,"max":2,"unit":"hours","qualifier":"Operative time for a single uncomplicated unilateral cyst; longer for endometriomas or adhesions."},"initial_assessment_documents":["Pelvic ultrasound report","Pelvic MRI report","Tumor marker results (CA-125)","AMH ovarian reserve test result","Previous gynecologic surgery reports","Recent blood test results"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay about 5-7 days including pre-op tests, surgery and discharge. Follow-up can be done remotely or at home."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Ask how the surgeon plans to remove the cyst intact if cancer is suspected, because that is important","scope":"procedure","source":{"url":"https://www.acog.org/womens-health/faqs/ovarian-cysts","host":"acog.org","quote":"If cancer is suspected, it is important to remove the cyst intact.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Ask whether the planned approach is laparoscopic or open, since open surgery can be needed for large cysts or suspected cancer","scope":"procedure","source":{"url":"https://www.acog.org/womens-health/faqs/ovarian-cysts","host":"acog.org","quote":"Open surgery may be done if cancer is suspected or if the cyst is too large to be removed by laparoscopy.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C4","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Check that the surgeon who consults with you is the same person who will carry out the procedure","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Check that the surgeon you consult with, will be the same person carrying out the procedure.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Heavy bleeding","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/conditions/ovarian-cyst/treatment/","host":"nhs.uk","quote":"heavy bleeding severe pain or swelling in your abdomen a high temperature (fever) dark or smelly vaginal discharge","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Severe pain or swelling in your belly","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/conditions/ovarian-cyst/treatment/","host":"nhs.uk","quote":"heavy bleeding severe pain or swelling in your abdomen a high temperature (fever) dark or smelly vaginal discharge","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W3","text":"Dark or smelly vaginal discharge","urgency":"contact_clinic","general":false,"source":{"url":"https://www.nhs.uk/conditions/ovarian-cyst/treatment/","host":"nhs.uk","quote":"heavy bleeding severe pain or swelling in your abdomen a high temperature (fever) dark or smelly vaginal discharge","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W4","text":"Severe difficulty breathing","urgency":"emergency","general":false,"source":{"url":"https://www.nhs.uk/tests-and-treatments/laparoscopy/","host":"nhs.uk","quote":"you have a very fast heartbeat you have pain in your chest you have severe difficulty breathing – you're gasping, choking or not able to get words out","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W5","text":"A high temperature (fever)","urgency":"contact_clinic","general":true,"source":{"url":"https://www.nhs.uk/conditions/ovarian-cyst/treatment/","host":"nhs.uk","quote":"heavy bleeding severe pain or swelling in your abdomen a high temperature (fever) dark or smelly vaginal discharge","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before 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recommended.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"technique_details":{"status":"ok","items":[{"id":"standard-multiport","name":"Standard multiport laparoscopic stripping cystectomy","how_it_works":{"text":"Several small cuts let the surgeon pass instruments through the abdomen","source":{"url":"https://www.nhs.uk/tests-and-treatments/laparoscopy/","host":"nhs.uk","quote":"If you're having surgery, more small cuts may need to be made in your tummy for the surgeon to pass their tools through.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"single-incision-laparoscopic","name":"Single-incision (single-port) laparoscopic 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